绝经妇女体成分与代谢综合征组分的相关性

目的:了解绝经妇女代谢综合征各组分异常的发生现状,以期得到预测绝经妇女代谢综合征各组分异常的体成分敏感指标。方法:选取2006-07/2007-08在北京妇产医院体检并被确诊为自然绝经的妇女181名。年龄41～60岁,绝经年限1～9年。测量181名绝经妇女身高、体质量、腰围、臀围、血压及腹部矢状径,测定其卵泡刺激素、黄体生成素、雌二醇、三酰甘油、高密度脂蛋白胆固醇、空腹血糖及体脂含量。观察绝经妇女代谢综合征各组分异常的发生情况。消除年龄、绝经年限及雌二醇水平的影响,对绝经妇女体成分指标与代谢综合征各组分进行偏相关分析。预测绝经妇女代谢综合征各组分发生异常的体成分敏感指标的选取。结果:①绝经妇女中心型肥胖(腰围≥80cm)、高三酰甘油(三酰甘油≥1.7mmol/L)、低高密度脂蛋白胆固醇(高密度脂蛋白胆固醇1.29mmol/L)、高血压(收缩压≥130mmHg(1mmHg=0.133kPa)或舒张压≥85mmHg)、高血糖(空腹血糖≥5.6mmol/L)的患病率分别为48.1%,31.5%,16.6%,38.7%,50.3%。②消除年龄、绝经年限及雌二醇水平的影响,体成分指标(体质指数、腰围、腰臀比、腹部矢状径、体脂含量)与三酰甘油、收缩压、舒张压、空腹血糖呈正相关,与高密度脂蛋白胆固醇呈负相关。③预测绝经妇女代谢综合征各组分发生异常的敏感指标及其临界值分别为:高三酰甘油:体质指数≥24.845kg/m2;低高密度脂蛋白胆固醇:腹部矢状径≥18.85cm;高血压:体质指数≥23.33kg/m2;高血糖:腹部矢状径≥18.10cm或体脂含量≥36.515%。结论:中心型肥胖及高血糖是绝经妇女最常见的代谢紊乱。肥胖是绝经妇女代谢综合征各组分发生异常的独立危险因素。初步发现预测绝经妇女代谢综合征各组分发生异常的体成分敏感指标及其临界值。     

围绝经期妇女体成分及静息能量代谢变化

背景：女性绝经后雌激素水平下降、年龄增长、活动水平下降都可能引起静息能量消耗的降低,进而引起绝经后女性体成分变化,导致疾病,如肥胖、骨折。 目的：观察绝经前、围绝经期、绝经后妇女体成分及静息代谢率的变化。 方法：收集门诊就诊的2 312例妇女,其中绝经前1 310例、围绝经期790例、绝经后212例,测定体成分和静息能量消耗。 结果与结论：①围绝经期和绝经后女性的全身脂肪百分比显著高于绝经前女性。②3组间的静息代谢率无显著差异,经体质量校正后围绝经期女性的每千克体质量静息代谢率显著低于绝经前女性。③绝经后女性的骨密度、股骨颈抗骨折能力、下肢最大肌力、下肢肌肉分布系数显著低于围绝经期女性和绝经前女性(P < 0.05)。④体质量、下肢肌肉分布系数与每千克体质量静息代谢率呈正相关,身高、体质量指数、全身脂肪含量与每千克体质量静息代谢率呈负相关。以上结果表明,绝经后女性体成分发生变化,身体脂肪含量增加,肌肉含量减少,骨量减少;骨骼、肌肉、关节功能处于退行性变;体成分改变与静息能量消耗之间存在一定的相互关系。 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

健康绝经妇女体成分差异对跟骨骨密度的影响

目的探讨锦州市健康绝经妇女身体质量指数(BMI)、左下肢肌肉含量及脂肪含量等身体组成成分与左侧跟骨骨密度(BMD)的关系。方法使用体成分仪及骨密度仪测量421例健康绝经妇女的体成分和左侧跟骨骨密度。结论左侧跟骨BMD与年龄呈负相关,与左下肢肌肉量、BMI呈正相关关系,而与左下肢脂肪量没有相关性。结论 BMI是影响绝经妇女BMD的重要因素,加强运动、增加身体肌肉含量对预防骨质疏松有重要作用。     

抗阻训练对绝经后女性身体成分、膝关节肌肉力量及动态平衡能力的影响

目的：探讨抗阻训练对绝经后女性身体成分、膝关节屈伸肌力及动态平衡能力的影响。方法：将25 名绝 经女性随机分为抗阻训练组和对照组,抗阻训练前后测试绝经后女性身体成分（ 体质量、体脂肪量、肌肉量、左 右下肢肌肉量）,左、右膝关节屈、伸肌力及动态平衡能力。结果：12 周抗阻训练可使绝经后女性体脂肪量显著 下降,左右下肢肌肉量及全身肌肉量均显著增加,而体质量在抗阻训练前后无显著差异;此外,12 周抗阻训练可 使绝经后女性左、右膝关节屈、伸肌肌力显著增加,闭眼状态下总体稳定指数、前后方向稳定指数及左右方向稳 定指数显著下降。结论：12 周抗阻训练可显著降低绝经后女性身体脂肪量、增加下肢肌肉量及膝关节肌肉力量, 改善动态平衡能力,对于预防绝经后女性跌倒及提高绝经后女性生存质量有重要意义。     

多层螺旋CT及后处理技术评价腹部及血管周围脂肪

背景：目前国内对腹部脂肪的测量多用单一层面的腹部脂肪面积来表示,而受脂肪分布不均一的影响,其并不能准确定量内脏脂肪含量。国内尚未见到使用多层螺旋CT测量血管周围脂肪体积的研究报道。 目的：探讨多层螺旋CT及其后处理技术在评价腹部及血管周围脂肪中的价值。 方法：采用16排多层螺旋CT对35例腹型肥胖患者进行腹部容积扫描,在GE(General Electric,通用电气公司) AW(Advantage Workstation)4.3工作站上使用容积再现技术观察腹部及血管周围脂肪的影像表现,并用Histogram软件测量腹部脂肪总体积、皮下脂肪体积、内脏脂肪体积、血管周围脂肪总体积,重复测量各项指标,比较2次测量体积值之间的差异。 结果与结论：多层螺旋CT及其后处理技术能直观地显示腹部及血管周围脂肪的分布,且可以准确地测量所扫描范围内所含脂肪的体积及分布在不同部位的脂肪体积。比较2次CT后处理所得腹部及血管周围脂肪组织的体积差异,两次处理所得数值间差异无显著性意义(P > 0.05)。提示多层螺旋CT及其后处理技术在评价腹部及血管周围脂肪分布与含量中是可行的,且具有可重复性。     

腿部磁共振图像脂肪分割方法的研究

腿部磁共振图像脂肪分割对于代谢综合征和代谢功能异常诊断具有重要意义,但皮下脂肪和肌肉间脂肪存在连通区域,难以分割。本文提出水平集算法和模糊C均值算法相结合的方法,对腿部磁共振图像脂肪和其他组织进行分割提取。实验结果表明,该方法能够较好地分割出腿部的皮下脂肪组织、肌肉间脂肪组织及其他组织。     

生物电阻抗法测量身体成分的可行性

目的 :比较双能X射线吸收法(DEXA)与生物电阻抗法(BAI)测量人体成分的相关性和一致性,探讨操作简单、便于携带的BIA人体成分测量仪的可靠性和实用性,为野外测量及其他大样本量多点测量提供参考。方法:对80例成人(男性31例,女性49例)分别采用人体脂肪测量仪(BC-601)、多频身体成分分析仪(MC-180)及LUNARDEXA测试仪测量15项身体成分。结果 :BC-601与MC-180比较,男性在推定骨量、水分率、内脏脂肪、右上肢脂肪率、右上肢肌肉量、躯干肌肉量及女性测量指标体脂率、左上肢脂肪率、右下肢脂肪率、左下肢脂肪率及总肌肉量,所测得的结果间差异无统计学意义;男、女性除水分率(男性不相关;女性负相关)外,其余均呈正相关;BC-601较MC-180会低估脂肪率、高估肌肉量,一致性分析在总体脂率及总肌肉量上仅在女性上表现较好,2种机器可以互相取代。BC-601与LUNARDEXA测试仪15项指标间呈正相关,男、女性右上肢肌肉量及女性推定骨量、男性四肢脂肪率时无差异;BC-601较LUNAR DEXA测试仪会低估躯干脂肪率,高估四肢脂肪率,低估四肢肌肉量,高估躯干肌肉量。成年男女及女性总体脂率上一致性表现较好。MC-180与LUNAR DEXA测试仪13项指标间相关性良好,除男性中推定骨量(低估)、成年男女中左上肌肌肉量(高估)外,均出现低估肌肉量,高估脂肪率的现象。一致性分析也仅在男性上表现较好。结论:BAI法在测量成年总体脂率及总肌肉量上可靠性较强。     

围绝经期和绝经后女性血清脂联素水平与身体成分之间的关系

目的 分析甘肃省中西部地区围绝经期和绝经后女性血清脂联素水平与身体组成之间的关系，探讨影响血清脂联素水平的因素。方法 采用生物电阻抗分析仪测量638例(围绝经期317例，绝经后321例)甘肃中西部女性体重、体质量指数(BMI)、腰臀比、脂肪量、体脂肪率、内脏脂肪含量和肌肉量；通过ELISA检测血清脂联素水平；采用Pearson相关分析和多元线性回归分析法探讨脂联素水平与身体成分之间的关系。结果 甘肃省中西部地区绝经后女性体重、肌肉量均呈下降趋势；腰围、腰臀比、体脂肪率、内脏脂肪含量呈上升趋势；BMI、脂肪量、脂联素水平无明显差异。从总体来看，脂联素水平与体脂肪率、内脏脂肪量成正相关，与肌肉量成负相关，其中内脏脂肪量是脂联素水平的主要影响因素。结论 甘肃中西部地区围绝经期和绝经后女性血清脂联素水平主要影响因素为内脏脂肪量。     

河南回族成人四肢肌肉量、脂肪量电阻抗参数及与围度的相关性

目的测定河南回族成人四肢肌肉量、脂肪量电阻抗参数,探讨四肢围度与肌肉量、脂肪量的相关性。方法采用身体成分分析仪测量1144例河南地区20岁以上回族成人的肌肉量、脂肪量,并测量身高、体重和四肢围度值。结果男性右侧臂围(30.87±1.98)cm、前臂围(26.02±2.45)cm、大腿中部围(51.09±3.64)cm、小腿围(36.79±2.12)cm,与对应肢体肌肉量、脂肪量高度线性相关(r=0.734,0.715,0.866,0.808)。女性臂围(27.07±2.54)cm,前臂围(22.02±2.66)cm,与对应肢体肌肉量、脂肪量显著性相关(r=0.635,0.682);大腿中部围(45.68±3.32)cm,小腿围(31.61±2.16)cm,与对应肢体肌肉量无关,而与脂肪量显著性相关(r=0.531,0.543)。结论通过测量肢体电阻抗参数可推测肢体肌肉量、脂肪量数值,河南回族成人四肢围度与肌肉量和(或)脂肪量内在相关。     

运脾化浊颗粒治疗代谢综合征疗效观察

目的:观察运脾化浊颗粒治疗代谢综合征(MS)的疗效。方法:选取2018-01-2020-12本院收治的200例MS患者,按随机数字表法将其分为2组,对照组(n=100)给予常规综合治疗,研究组(n=100)在对照组治疗基础上给予运脾化浊颗粒。比较两组内脏脂肪体积、代谢指标水平变化及疗效差异。结果:研究组总有效率高于对照组(P<0.05)。治疗前,两组内脏脂肪体积及各相关代谢指标水平比较,差异无统计学意义(P>0.05)。治疗后两组患者内脏脂肪体积均降低(P<0.05),且研究组较对照组降低更明显(P<0.05)。治疗中,研究组各项代谢指标优于治疗前(P<0.05);治疗后,两组各项代谢指标优于治疗前(P<0.05);治疗中、治疗后,研究组各项代谢指标优于对照组(P<0.05)。结论:运脾化浊颗粒治疗MS疗效肯定,能缩小内脏脂肪体积,改善机体代谢。     

Does waist indicate dyslipidemia better than BMI in Korean adult population?

Obesity is an independent and modifiable risk factor for cardiovascular disease, and known as a core of the metabolic syndrome. Obesity has been largely diagnosed based upon anthrompometric measurements like waist circumference (WC) and body mass index (BMI). We sought to determine associations between anthropometric measurements and dyslipidemia in a community adult sample composed of 1,032 community residents (356 men, 676 women) aged 50 yr and over in Namwon, Korea. Blood tests for lipid profiles, including total cholesterol (TC) and HDL cholesterol (HDL) were performed, and dyslipidemia was defined as TC/HDL greater than 4. Anthropometric measurements included WC, waist-to-height ratio (WHtR), waist-to-hip ratio, and BMI. All anthropometric measures were categorized into quartiles and evaluated for associations with dyslipidemia. TC/HDL showed the significant associations with the anthropometric measures, independently of potential confounders. In women, increases of obesity indexes by quartile analyses showed linear increases of odds ratios for dyslipidemia (p values <0.01 by trend test). In men, except BMI, same patterns of association were noted. WC and WHtR were significantly associated with dyslipidemia in Korean adult population. As a simple and non-invasive method for a detection of obesity and dyslipidemia, anthropometric measurements could be efficiently used in clinical and epidemiologic fields.     

Application of alternative anthropometric measurements to predict metabolic syndrome

OBJECTIVE:

The association between rarely used anthropometric measurements (e.g., mid-upper arm, forearm, and calf circumference) and metabolic syndrome has not been proven. The aim of this study was to assess whether mid-upper arm, forearm, calf, and waist circumferences, as well as waist/height ratio and waist-to-hip ratio, were associated with metabolic syndrome.

METHODS:

We enrolled 387 subjects (340 women, 47 men) who were admitted to the obesity outpatient department of Istanbul Medeniyet University Goztepe Training and Research Hospital between September 2010 and December 2010. The following measurements were recorded: waist circumference, hip circumference, waist/height ratio, waist-to-hip ratio, mid-upper arm circumference, forearm circumference, calf circumference, and body composition. Fasting blood samples were collected to measure plasma glucose, lipids, uric acid, insulin, and HbA1c.

RESULTS:

The odds ratios for visceral fat (measured via bioelectric impedance), hip circumference, forearm circumference, and waist circumference/hip circumference were 2.19 (95% CI, 1.30-3.71), 1.89 (95% CI, 1.07-3.35), 2.47 (95% CI, 1.24-4.95), and 2.11(95% CI, 1.26-3.53), respectively. The bioelectric impedance-measured body fat percentage correlated with waist circumference only in subjects without metabolic syndrome; the body fat percentage was negatively correlated with waist circumference/hip circumference in the metabolic syndrome group. All measurements except for forearm circumference were equally well correlated with the bioelectric impedance-measured body fat percentages in both groups. Hip circumference was moderately correlated with bioelectric impedance-measured visceral fat in subjects without metabolic syndrome. Muscle mass (measured via bioelectric impedance) was weakly correlated with waist and forearm circumference in subjects with metabolic syndrome and with calf circumference in subjects without metabolic syndrome.

CONCLUSION:

Waist circumference was not linked to metabolic syndrome in obese and overweight subjects; however, forearm circumference, an unconventional but simple and appropriate anthropometric index, was associated with metabolic syndrome and bioelectric impedance-measured visceral fat, hip circumference, and waist-to-hip ratio.     

Relative contribution of aging and menopause to changes in lean and fat mass in segmental regions

Objective: The aim of the study was to investigate the relative contribution of aging and menopause to the changes in lean and fat mass in segmental regions. Materials and methods: Subjects were 365 pre- and 201 postmenopausal Japanese women aged between 20 and 70 years old. Age, height, weight, body mass index (BMI, Wt/Ht²), age at menopause, years since menopause (YSM), and menopausal status were recorded. Lean and fat mass of the arms, trunk, legs, total body, and the ratio of trunk fat mass to leg fat mass amount (trunk–leg fat ratio) were measured by dual-energy X-ray absorptiometry (DEXA). Regional (arms, lumbar spine, pelvis, legs, and total body) bone mineral density (BMD) were measured by DEXA. Results: Total body lean mass and regional BMD decreased (P<0.001), while percentage of body fat, trunk fat mass, and trunk–leg fat ratio increased (P<0.001) with aging and after menopause. On multiple regression analyses, trunk and total body lean mass were inversely correlated with menopausal status (P<0.001 and 0.05, respectively) but not with age. Trunk fat mass, trunk–leg fat ratio, and percentage of body fat were positively correlated with age (P<0.01) but not with menopausal status. Regional BMD were more inversely correlated with menopausal status (P<0.001) than age. Conclusion: Decrease in lean mass and BMD are more menopause-related, while the shift toward upper body fat distribution and overall adiposity are more age-related. Lean tissue is similar to bone tissue from the viewpoint of more undergoing menopausal effect.     

Low sex hormone-binding globulin is associated with low high-density lipoprotein cholesterol and metabolic syndrome in women with PCOS

BACKGROUND: Decreased high-density lipoprotein cholesterol (HDL-C) and sex hormone-binding globulin (SHBG) levels, and the metabolic syndrome, are all closely associated with a higher prevalence of atherosclerotic cardiovascular disease. We investigated the association between HDL-C, SHBG and the metabolic syndrome in women with polycystic ovary syndrome (PCOS). METHODS AND RESULTS: Among 106 young Taiwanese women (mean age +/- SD, 24.9 +/- 4.8 years) with PCOS, 69 (65.1%) women had an HDL-C level <50 mg dl(-1). The level of HDL-C was highly correlated with that of serum SHBG (gamma = 0.6034, P < 0.0001). The SHBG level was significantly lower in subjects with an HDL-C <50 mg dl(-1) than that in subjects with an HDL-C > or =50 mg dl(-1). Using multiple linear regression models with adjustment for age, BMI and other anthropometric, metabolic, liver function and hormonal variables, we showed serum SHBG to be independently correlated with HDL-C. Based on logistic regression analysis with adjustment for age, the SHBG level was significantly lower in women with PCOS with the metabolic syndrome (odds ratio = 0.92, P = 0.003). CONCLUSIONS: Low levels of SHBG in women with PCOS were associated with low levels of HDL-C, independent of insulin resistance and obesity. The SHBG level was inversely related to the occurrence of metabolic syndrome, further strengthening the potential link between SHBG levels and cardiovascular disease in women with PCOS.     

Factor analysis of climacteric symptoms in Japan

OBJECTIVES: To identify menopausal and climacteric symptoms among midlife Japanese women by factor analysis of symptom frequency and severity data. METHODS: Demographic information, anthropometric data, 2-week recalls of 82 symptoms, and assessment of epidemiological menopausal and self-defined konenki (climacteric) status were collected from 140 Japanese women living in Kyoto and Fukushima prefectures. Factor analysis was performed using symptom frequency scores and frequency-severity scores. To identify the symptoms constituting menopausal and climacteric syndromes in Japan, regression scores for individual factors were compared by menopausal and konenki status groups using non-parametric tests. RESULTS: Among 140 women aged 49.5+/-3.0 years (mean+/-S.D.), the three most prevalent symptoms were shoulder stiffness, memory loss, and stress. Analysis of frequency data resulted in an eight-factor solution, and frequency-severity data in a seven-factor solution. Anxiety and depression factors and a sexual-vasomotor factor were observed in almost all factor solutions, with additional factors comprised of psychosomatic and somatic symptoms. Anxiety scores differed by menopausal status, depression scores by konenki status, and sexual-vasomotor scores by both. Chilliness was highly correlated with sexual-vasomotor symptoms and frequency scores differed significantly between menopausal but not konenki groups. CONCLUSIONS: Sexual-vasomotor symptoms constitute a robust menopausal and konenki symptom grouping among Japanese women, but do not include night sweats or the foreign word hotto furasshu, yet do include chilliness, which may reflect thermoregulatory instability. Overlap of factors displaying significant differences between menopausal and konenki groups indicate a transition to a more medicalized concept of konenki in use by Japanese women.     

Anthropometric determination of body volume, body density and segmental volume in adult Indian women

Body density, total body volume, leg volume and arm volume of 65 young Indian women 20-25 years were measured experimentally. In addition, a series of 61 anthropometric measurements were also taken on each subject. Correlations of leg volume with total body volume and body density were 0.91 and -0.73 respectively and of arm volume with total body volume and body density were 0.84 and -0.66 respectively. Hip girth alone showed a very high positive correlation (r = 0.94) with body volume and on selective stepwise multiple regression analysis, a combination of even four anthropometric measurements, namely, hip girth, lower thigh girth, ankle girth and shoulder diameter gave an extremely high positive multiple correlation coefficient (R = 0.98) with body volume. Selective stepwise multiple linear regression analysis was conducted also to estimate leg volume, arm volume and body density and stepwise regression equations up to 4th step for estimating each parameter are given.     

THE CLINICAL AND NEURO-ELECTROPHYSIOLOGIC STUDY ON CORTICOBASAL DEGENERATION

目的：探讨皮质基底节变性(CBD)患者的临床和神经电生理特征。方法：对29例临床诊断为CBD患者，系统分析其临床症状、体征、常规化验检查、脑CT／MRI、SPECT以及神经电生理改变，并与其它疾病相对比。结果：结果显示，29例患者均出现不对称性帕金森样表现，皮层功能受损占79．3％，其它功能障碍占37．9％。21例患者脑CT或MRI显示不对称性脑萎缩，SPECT显示额顶区低灌注表现，以受损肢体的功能区较明显。EEG显示19例患者出现不对称性慢波，伴有肌阵挛的15例病人，表面肌电图显示患肢随意运动时可诱发巨大电位，皮层反应增强，SEP无特殊变化，运动诱发电位检查，26例患者中枢运动传导时间正常。结论：CBD是一种累及皮层和基底节、病程以缓慢进展为特征的变性性疾病。大部分患者可出现帕金森综合征样表现，皮层及其他运动功能障碍。脑影象学显示额顶叶萎缩。神经电生理检查表现为皮层兴奋性增强，而锥体束传导功能正常。     

Prevalence of metabolic syndrome during menopausal transition Tehranian women: Tehran Lipid and Glucose Study (TLGS)

OBJECTIVE: This study was conducted to assess the prevalence of metabolic syndrome (MetS) in Tehranian women during menopausal transition. DESIGN: In this cross sectional study 2182 subjects, pre-menopausal (pre-M) n=537, menopausal (M) n=311 and post-menopausal (post-M) n=1334 were selected from 15005 participants of the TLGS and assessed for MetS risk factors. All MetS components were evaluated following age adjustment according to the ATPIII criteria. RESULTS: The mean ages of post-M, M and pre-M women were 61.0+/-4.3, 53.0+/-4.0 and 47.0+/-1.9 years, respectively. The prevalence of MetS in subjects was 63% (53%, 54% and 69%) in pre-M, M and post-M women respectively. HDL-c levels was significantly higher in post-M women in comparison to pre-M women (p<0.001). TG levels, FPG and waist circumference was significantly higher in post-M women in comparison to pre-M women (p<0.05). The most frequent markers of MetS were low HDL-c and high diastolic blood pressure in post-M women. CONCLUSION: It is concluded that the frequency of MetS is significantly higher in post-M women as compared to pre-M women; low HDL-c and high diastolic blood pressure is the most frequent feature in comparison to other factors.     

Leigh综合征的影像诊断(附二例报告)

目的报告2例Leigh综合征的影像学及电镜改变特点,探讨影像学检查的诊断价值.方法对2例具有典型Leigh综合征临床表现的患儿行影像学及,电镜检查,2例均行颅脑CT及MRI检查,1例行腓肠肌组织电镜观察,另1例行外周血的白细胞电镜观察.结果2例于CT上均表现双侧基底节及丘脑对称性低密度灶,MRI均表现双侧基底节、丘脑及脑干多发对称性长T1长T2信号.2例电镜均提示能量代谢功能障碍.结论影像学检查,结合电镜观察对诊断Leigh综合征有重要价值,MRI比CT更有利于诊断此病.